Provider Demographics
NPI:1063914935
Name:FAITH DUNKEL, PSY.D., LLC
Entity type:Organization
Organization Name:FAITH DUNKEL, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:973-826-0335
Mailing Address - Street 1:8 HILLSIDE AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2129
Mailing Address - Country:US
Mailing Address - Phone:973-826-0335
Mailing Address - Fax:
Practice Address - Street 1:8 HILLSIDE AVE STE 108
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2129
Practice Address - Country:US
Practice Address - Phone:973-826-0335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100565800103TA0700X, 103TC2200X, 103TF0000X, 103TP2701X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty